Provider Demographics
NPI:1063464212
Name:ALBANY AREA COMMUNITY SVC. BOARD
Entity Type:Organization
Organization Name:ALBANY AREA COMMUNITY SVC. BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARANKO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:229-430-2954
Mailing Address - Street 1:PO BOX 1988
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-1988
Mailing Address - Country:US
Mailing Address - Phone:229-430-2954
Mailing Address - Fax:229-430-2956
Practice Address - Street 1:1120 W BROAD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-4397
Practice Address - Country:US
Practice Address - Phone:229-430-2954
Practice Address - Fax:229-430-2956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000744895FMedicaid
GA000601796CMedicaid
GA055002371AMedicaid
GA000601796FMedicaid
GA000601796LMedicaid
GA000601796PMedicaid
GA000932511BMedicaid
GA000601796BMedicaid
GA000744895DMedicaid
GA000601796OMedicaid
GA000744895CMedicaid
GA000601796AMedicaid
GA000601796DMedicaid
GA000601796HMedicaid
GA000601796AMedicaid